/* SecureForm Default CSS Style File */
/* For SecureForm Form Builder */

table {
	border: 0;
	}
tr {
	vertical-align: top;
	}
td, th {
	padding: 5px;
	}
th {
	font-weight: bold;
	text-align: left;
	}

blockquote {
	margin: 10px 10px 10px 25px;
	border-left: 2px solid #CCC;
	padding-left: 0 0 0 5px;
	}

dt {
   font-weight: bold;
   margin-left: 32px;
   text-indent: -32px;
   }

dd {
   font-weight: normal;
   margin: 5px 0 10px 25px;
   border-left: 2px solid #CCC;
   padding-left: 5px;
   }


h1 {
	font-size: 24px;
	}
h2 {
	font-size: 20px;
	}
h3 {
	font-size: 16px;
	}
h4,h5,h6,h7 {
	font-size: 14px;
	}

form, img {
	padding: 0;
	margin: 0;
	}
				
input, select {
   border: 2px solid #DDD;
   color: #000;
   padding: 4px;
	border-radius:3px;
   }
textarea {
   background: #FFF;
   border: 2px solid #DDD;
   font-family: "Courier New", Courier, monospace;
   font-weight: normal;
   padding: 4px;
	border-radius: 5px;
   color: black;
   }

input:focus, select:focus, textarea:focus {
   background: #EEE;
   border: 2px solid #CCC;
   color: black;
   }

/* Css + bootstrap-buttons */
input[type="button"], input[type="submit"] {
	cursor: pointer;
	border: 1px solid #979797;
   border-radius:4px;
   -webkit-border-radius:4px;
   -moz-border-radius:4px;
   background-color:#EEEEEE;
   background-image:-o-linear-gradient(bottom, #CCC 40%, #FFFFFF );
   background-image:-moz-linear-gradient(bottom, #CCC 40%, #FFFFFF );
   background-image:-webkit-linear-gradient(bottom, #CCC 40%, #FFFFFF );
   background-image:-ms-linear-gradient(bottom, #CCC 40%, #FFFFFF );
 //  text-shadow:1px 1px 1px #FFFFFF;	
   }

/* Bootstrap reversions */
input.btn {
	border: 1px solid transparent;
	background-image: none;
	text-shadow: none;
	color: #FFF;
	}
input.btn-primary {
	background-color: #337ab7;
	border-color: #002242;
	}
input.btn-success {
	background-color: #5cb85c;
	border-color: #5cb85c;
	}
input.btn-info {
	background-color: #5bc0de;
	border-color: #5bc0de;
	}
input.btn-warning {
	background-color: #f0ad4e;
	border-color: #f0ad4e;
	}
input.btn-danger  {
	background-color: #d9534f;
	border-color: #d9534f;
	}
input.btn-default  {
	background-color: #FFFFFF;
	border-color: #CCCCCC;
	color: #000;
	}
						

/* for IE<9 HTML5 compatibility */
nav, article, header, footer {
   display: block;
	}
	
	
/* ********************************* */
/* BEGIN FORM VALIDATION CSS */

/* Z-INDEX */
 .formError { z-index: 990; }
    .formError .formErrorContent { z-index: 991; }
    .formError .formErrorArrow { z-index: 996; }
    .ui-dialog .formError { z-index: 5000; }
    .ui-dialog .formError .formErrorContent { z-index: 5001; }
    .ui-dialog .formError .formErrorArrow { z-index: 5006; }


.inputContainer {
	position: relative;
	float: left;
}

.formError {
	position: absolute;
	top: 300px;
	left: 300px;
	display: block;
	cursor: pointer;
	text-align: left;
}

.formError.inline {
	position: relative;
	top: 0;
	left: 0;
	display: inline-block;
}

.ajaxSubmit {
	padding: 20px;
	background: #55ea55;
	border: 1px solid #999;
	display: none;
}

.formError .formErrorContent {
	width: 100%;
	background: #ee0101;
	position:relative;
	color: #fff;
	min-width: 120px;
	font-size: 11px;
	border: 2px solid #ddd;
	box-shadow: 0 0 6px #000;
	-moz-box-shadow: 0 0 6px #000;
	-webkit-box-shadow: 0 0 6px #000;
	-o-box-shadow: 0 0 6px #000;
	padding: 4px 10px 4px 10px;
	border-radius: 6px;
	-moz-border-radius: 6px;
	-webkit-border-radius: 6px;
	-o-border-radius: 6px;
}

.formError.inline .formErrorContent {
	box-shadow: none;
	-moz-box-shadow: none;
	-webkit-box-shadow: none;
	-o-box-shadow: none;
	border: none;
	border-radius: 0;
	-moz-border-radius: 0;
	-webkit-border-radius: 0;
	-o-border-radius: 0;
}

.greenPopup .formErrorContent {
	background: #33be40;
}

.blackPopup .formErrorContent {
	background: #393939;
	color: #FFF;
}

.formError .formErrorArrow {
	width: 15px;
	margin: -2px 0 0 13px;
	position:relative;
}
body[dir='rtl'] .formError .formErrorArrow,
body.rtl .formError .formErrorArrow {
	margin: -2px 13px 0 0;
}

.formError .formErrorArrowBottom {
	box-shadow: none;
	-moz-box-shadow: none;
	-webkit-box-shadow: none;
	-o-box-shadow: none;
	margin: 0px 0 0 12px;
	top:2px;
}

.formError .formErrorArrow div {
	border-left: 2px solid #ddd;
	border-right: 2px solid #ddd;
	box-shadow: 0 2px 3px #444;
	-moz-box-shadow: 0 2px 3px #444;
	-webkit-box-shadow: 0 2px 3px #444;
	-o-box-shadow: 0 2px 3px #444;
	font-size: 0px;
	height: 1px;
	background: #ee0101;
	margin: 0 auto;
	line-height: 0;
	font-size: 0;
	display: block;
}

.formError .formErrorArrowBottom div {
	box-shadow: none;
	-moz-box-shadow: none;
	-webkit-box-shadow: none;
	-o-box-shadow: none;
}

.greenPopup .formErrorArrow div {
	background: #33be40;
}

.blackPopup .formErrorArrow div {
	background: #393939;
	color: #FFF;
}

.formError .formErrorArrow .line10 {
	width: 13px;
	border: none;
}

.formError .formErrorArrow .line9 {
	width: 11px;
	border: none;
}

.formError .formErrorArrow .line8 {
	width: 11px;
}

.formError .formErrorArrow .line7 {
	width: 9px;
}

.formError .formErrorArrow .line6 {
	width: 7px;
}

.formError .formErrorArrow .line5 {
	width: 5px;
}

.formError .formErrorArrow .line4 {
	width: 3px;
}

.formError .formErrorArrow .line3 {
	width: 1px;
	border-left: 2px solid #ddd;
	border-right: 2px solid #ddd;
	border-bottom: 0 solid #ddd;
}

.formError .formErrorArrow .line2 {
	width: 3px;
	border: none;
	background: #ddd;
}

.formError .formErrorArrow .line1 {
	width: 1px;
	border: none;
	background: #ddd;
}
	
/* END FORM VALIDATION CSS */
/* ********************************* */

/* ********************************* */
/* Ink Signatures */

.x_inksig {
	border: 1px inset #CCC;
	border-radius:5px;		
	}




/* End Ink Signatures */
/* ********************************* */

/* ********************************* */
/* GeoLocation */

.x_getgeo {
	border: 1px solid #CCC;
	background-color: #EEE;
	border-radius:3px;		
	width:20px;
	height:20px;
	padding:2px;
	background-image: url(https://d4hm2u4pioc0c.cloudfront.net/icons/png/o/blue_dark_grey/16x16/earth2.png);
	}

/* End GetLocation */
/* ********************************* */
	


/* SECUREFORM DEFAULT CSS */

/* Do not edit the contents of this block, it will */
/* be auto-regenerated each time you update your form */

body {
	padding: 10px;
	margin: 0;
	background-color: #FFFFFF;
	color: #333333;
   font-size: 13px;
	font-family: Arial, Helvetica, sans-serif;
	line-height: 1.5em;
	}

td, th, p, li, blockquote, a, dt, dd {
	color: #333333;
   font-size: 13px;
	font-family: Arial, Helvetica, sans-serif;
	line-height: 1.5em;
	}

h1,h2,h3,h4,h5,h6,h7 {
	color: #333333;
	font-family: Arial, Helvetica, sans-serif;
	font-weight: bold;
	}

input, select, textarea {
	font-family: Arial, Helvetica, sans-serif;
   font-size: 13px;
	}

.x_getgeo {
   border: 1px solid #CCC;
   background-color: #EEE;
   border-radius:5px;
   padding:2px;
   }	
/* SECUREFORM DEFAULT CSS */






























































































































































































































/* CSS below copied from the PPSD.com website */


body {
  font: 12px Arial, Helvetica, sans-serif;
  color: #000;
  background: #FFF;
  text-align: center;
}

a {
  color: #36689A;
}

h1,
h2,
h3,
h4,
h5 {
}

h2 {
  font-size: 2em;
  padding: 1.5em 0 .3em;
}

.clear {
  clear: both;
}

img {
  max-width: 100%;
}

/* HEADER */
.header h1,
.header h2 {
  display: block;
  margin: 0;
  padding: 0;
}

.header h1 img {
  height: 70px !important;
}

/* FORMS */
input[type=text],
input[type=url],
input[type=email],
input[type=tel],
input[type=number],
input[type=password],
textarea {
  border: none;
  background: #EFEFEF;
  width: 100%;
  padding: .3em;
  -webkit-box-sizing: border-box;
  -moz-box-sizing: border-box;
  box-sizing: border-box;
  -webkit-box-shadow: inset 1px 1px 5px rgba(0, 0, 0, 0.2);
  -moz-box-shadow: inset 1px 1px 5px rgba(0, 0, 0, 0.2);
  box-shadow: inset 1px 1px 5px rgba(0, 0, 0, 0.2);
}

input[type=text].mini-text-box {
  width: 3em;
}

input[type="submit"] {
  text-align: center;
  width: auto;
  margin: 1.625em auto;
  padding: .6em 1em;
  background: #36689A;
  color: #FFF;
  cursor: pointer;
  font-size: 1.2em;
  font-weight: bold;
  box-shadow: 0px 1px 3px rgba(0, 0, 0, 0.3);
  -moz-box-shadow: 0px 1px 3px rgba(0, 0, 0, 0.3);
  -webkit-box-shadow: 0px 1px 3px rgba(0, 0, 0, 0.3);
  border: none;
  border-radius: .4062em;
  -moz-border-radius: .4062em;
  -webkit-border-radius: .4062em;
}

input[type="submit"]:hover {
  background: #EEE;
  color: #36689A;
}

label {
  display: block;
  width: 100%;
  -webkit-box-sizing: border-box;
  -moz-box-sizing: border-box;
  box-sizing: border-box;
}

label.radio-label,
label.checkbox-label {
  display: inline-block;
  width: auto;
  white-space: pre-wrap;
}

.checkbox1-3,
.checkbox1-2,
.radio1-3,
.radio1-2 {
  display: inline-block;
  white-space: nowrap;
  padding: 0 1.2em 1em 0;
}

.auto-h {
  height: auto;
}

.auto-h label {
  white-space: normal;
}

.required,
.required label {
  color: #d10000;
}

.required-agreement {
  display: block;
  padding: 1em .3em;
  margin: 1em 0;
  background: #ffd8d8;
}

.canvas_o {
  max-width: 100%;
  border: 1px inset #EEE;
  border-radius: 5px;
  -webkit-border-radius: 5px;
  -moz-border-radius: 5px;
  -webkit-box-shadow: inset 1px 1px 5px rgba(0, 0, 0, 0.2);
  -moz-box-shadow: inset 1px 1px 5px rgba(0, 0, 0, 0.2);
  box-shadow: inset 1px 1px 5px rgba(0, 0, 0, 0.2);
}

.help-text {
  color: #999;
  font-size: .9em;
}

.policy-text {
  height: 100px;
  overflow: scroll;
  padding: .5em 1em;
  border-radius: 5px;
  -webkit-border-radius: 5px;
  -moz-border-radius: 5px;
  -webkit-box-shadow: inset 1px 1px 5px rgba(0, 0, 0, 0.2);
  -moz-box-shadow: inset 1px 1px 5px rgba(0, 0, 0, 0.2);
  box-shadow: inset 1px 1px 5px rgba(0, 0, 0, 0.2);
  background: #FAFAFA;
}

.submitted-entry {
  font-weight: bold;
}

/* LAYOUT */
.patient-form-container {
  margin: 2em auto;
  padding: 0 .5em;
  text-align: left;
  max-width: 1000px;
  position: relative;
  -webkit-box-sizing: border-box;
  -moz-box-sizing: border-box;
  box-sizing: border-box;
}

.patient-form-section {
  border: solid 1px #FFF;
  -webkit-box-sizing: border-box;
  -moz-box-sizing: border-box;
  box-sizing: border-box;
  width: 100%;
}

.patient-form-section:after {
  content: ".";
  display: block;
  clear: both;
  visibility: hidden;
  line-height: 0;
  height: 0;
}

.patient-form-section {
  display: inline-block;
}

html[xmlns] .patient-form-section {
  display: block;
}

* html .patient-form-section {
  height: 1%;
}

.patient-form-section p.section-title {
  clear: both;
  padding: 3em .3em .3em;
  margin: 0;
  font-size: 1.3em;
  text-transform: uppercase;
  font-weight: bold;
  border-top: solid 2px #CCC;
}


.patient-intake-form {
  margin: 0;
  padding: 0;
}

.submit-container {
  text-align: center;
}

.box1-1,
.box1-2,
.box1-3,
.box2-3,
.box1-4,
.box3-4,
.box1-5,
.box1-8 {
  padding: .3em;
  -webkit-box-sizing: border-box;
  -moz-box-sizing: border-box;
  box-sizing: border-box;
  position: relative
}

.col1-2 {
  -webkit-box-sizing: border-box;
  -moz-box-sizing: border-box;
  box-sizing: border-box;
  position: relative
}

.alt {
  background: #DDD;
}

.patient-form-section.medicare-only {
  background: #f7f4e1;
}

.alt input[type=text],
.alt input[type=url],
.alt input[type=email],
.alt input[type=tel],
.alt input[type=number],
.alt input[type=password],
.alt textarea {
  /* background: #FFF; */
}

@media screen and (min-width: 480px) {
  /* HEADER */
  .header {
    width: 100%;
  }

  .header:after {
    content: ".";
    display: block;
    clear: both;
    visibility: hidden;
    line-height: 0;
    height: 0;
  }

  .header {
    display: inline-block;
  }

  html[xmlns] .header {
    display: block;
  }

  * html .header {
    height: 1%;
  }

  .header h1 {
    text-align: left;
    float: left;
    width: 70%;
  }

  .header h2 {
    text-align: right;
    float: right;
    width: 30%;
  }

  /* FORMS */
  label {
    overflow: hidden;
  }
*/

  /* LAYOUT */
  .patient-form-container {
    padding: 0 2em;
  }

  .patient-form-section {
    border-bottom: none;
  }

  .patient-form-section p.section-title {
    border-bottom: solid 1px #FFF;
  }


  .box1-1,
  .box1-2,
  .box1-3,
  .box2-3,
  .box1-4,
  .box3-4,
  .box1-5,
  .box1-8 {
    float: left;
    border-right: solid 1px #FFF;
    border-bottom: solid 1px #FFF;
    min-height: 4em;
  }

  .clearfix,
  .first {
    clear: both;
  }

  .col1-2 {
    float: left;
  }

  .col1-2:after {
    content: ".";
    display: block;
    clear: both;
    visibility: hidden;
    line-height: 0;
    height: 0;
  }

  .col1-2 {
    display: inline-block;
  }

  html[xmlns] .col1-2 {
    display: block;
  }

  * html .col1-2 {
    height: 1%;
  }

  .box1-1,
  .last {
    border-right: none;
  }

  .box1-1 {
    width: 100%;
  }

  .box1-2,
  .col1-2 {
    width: 50%;
  }

  .box1-3 {
    width: 33%;
  }

  .box1-3.last {
    width: 34%;
  }

  .box2-3 {
    width: 66%;
  }

  .box2-3.last {
    width: 67%;
  }

  .box1-4 {
    width: 25%;
  }

  .box3-4 {
    width: 75%;
  }

  .box1-5 {
    width: 20%;
  }

  .box1-8 {
    width: 12.5%;
  }

  .auto-h {
    height: auto;
  }

  .auto-h label {
    white-space: normal;
  }

  .check-columns .checkbox1-3,
  .radio-columns .radio1-3 {
    -webkit-box-sizing: border-box;
    -moz-box-sizing: border-box;
    box-sizing: border-box;
    float: left;
    width: 33%;
    white-space: normal;
    padding: 0 .5em 1em;
    min-height: 45px;
  }

  .check-columns .checkbox1-2,
  .radio-columns .radio1-2 {
    -webkit-box-sizing: border-box;
    -moz-box-sizing: border-box;
    box-sizing: border-box;
    float: left;
    width: 50%;
    white-space: normal;
    padding: 0 .5em 1em;
    min-height: 45px;
  }
}

/*New Styles*/

.input-with-check {
  float: right;
  width: calc(100% - 70px) !important;
}

@media screen and (min-width: 480px) {
  .check-field-but-radio {
    padding-bottom: 0 !important;
  }

  .check-field-but-radio .radio1-3 {
    padding-bottom: 0 !important;
  }
}



label input[type="checkbox"] {
cursor: pointer !important;
}

p, ul, li {
font-family: "Avenir Next W01",sans-serif !important;
color: #7c7c7c;
font-size:14px;
font-weight:bold;
}


h3 {
color: #616db2 !important;
font-family: "Avenir Next W01",sans-serif !important;
font-size: 1.6rem !important;
}

h4 {
color: #616db2 !important;
font-family: "Avenir Next W01",sans-serif !important;
font-size: 2.4rem !important;
background-color: #efefef !important;
padding:10px !important;
font-weight: bold !important;
}

h5 {
color: #616db2 !important;
font-size: 1.8rem !important;
font-family: "Avenir Next W01",sans-serif !important;
padding-bottom: 6px  !important;
border-bottom: 2px solid #616db2  !important;
font-weight: bold !important;
text-transform: uppercase;
padding-top: 6px;
border-top: 1px solid #616db2;
}

label {
//color: #5160A4 !important;
font-family: "Avenir Next W01",sans-serif !important;
font-size: 1.4rem !important;
}

.x_inksig {
border:2px solid #ddd;
}

legend {
color: #616db2 !important;
padding: 10px;
font-family: "Avenir Next W01",sans-serif !important;
font-size: 1.4rem !important;
border-bottom: 0px solid #fff !important;
text-transform: uppercase;
font-weight:bold;
}

input[type="radio"], input[type="checkbox"] {
width: 1.5em;
height: 1.5em;
cursor: pointer;
vertical-align: top !important;
margin-top: 0px !important;
margin-bottom: 0px !important;
}

label {
cursor: pointer;
}

input[disabled] {
cursor: not-allowed !important;
}

@font-face {
  font-family: "Avenir Next W01";
  font-style: normal;
  font-weight: 400;
  src: url("https://fast.fonts.net/dv2/14/49c5f3e1-5867-4b1d-a843-2d07fa60d85d.woff2?d44f19a684109620e4841471a090e8180c939ac9c7c4f6903e1845dc7304a4cea2d84cf76772abf46d72988c476972519a5e10391987efa0d70a6c4c4b80d18856ae0b45a581e47f8a09c3795180d24b97f88c05ac6235&projectId=4543073c-9d10-4e42-b2fd-7ca56afeed31") format("woff2");
}